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Pregnant With an IUD: Complete Guide

Falling pregnant while an intrauterine device (IUD or coil) is fitted is uncommon but not impossible, and it needs prompt medical attention. This guide explains why it can happen, what your care team will check first, and the decisions you may need to make about the coil itself.

Why it can happen

IUDs (both the hormonal coil, such as Mirena or Kyleena, and the copper coil) are among the most reliable forms of contraception available, but no method is completely foolproof. A pregnancy can occur if:

  • The IUD has moved out of its correct position in the womb (partial or full expulsion), sometimes without you noticing.
  • The device was fitted incorrectly or has slipped since insertion.
  • You conceived in the short window right after insertion, before it had taken full effect.
  • Very rarely, the device fails even when correctly placed and positioned.

Because the coil sits inside the uterus rather than blocking the fallopian tubes, a pregnancy that does occur alongside an IUD carries a higher relative chance of being ectopic (developing outside the womb, usually in a fallopian tube) compared with pregnancies in someone using no contraception. This is why urgent assessment matters, even if you feel completely well.

What happens next

If you get a positive pregnancy test while your IUD is still fitted, contact your GP or an Early Pregnancy Unit (EPU) as soon as possible — do not wait for a routine appointment. You'll typically be offered:

  • An ultrasound scan to confirm where the pregnancy is developing (in the womb or, less commonly, in a tube or elsewhere) and to locate the IUD.
  • A check of the IUD threads, if they're visible, and an assessment of whether the coil can be safely removed.
  • A discussion about your options, including whether you wish to continue the pregnancy.

If the pregnancy is confirmed as being inside the uterus and the threads are accessible, your clinician will usually recommend removing the IUD as early as possible. Leaving it in place is linked to a higher chance of miscarriage, infection, and preterm birth later in pregnancy, so removal is generally the safer path when it can be done straightforwardly.

When the IUD stays in place

Sometimes the threads can't be seen or the coil is positioned in a way that makes removal risky in itself. In this situation, your team may recommend leaving the IUD where it is and monitoring the pregnancy more closely, since attempting removal could cause more harm than leaving it be. You'll usually be told to watch for and report:

  • Cramping or pelvic pain that feels different from normal pregnancy twinges.
  • Any vaginal bleeding or unusual discharge.
  • A raised temperature, flu-like symptoms, or feeling generally unwell (possible signs of infection).
  • Sudden, severe one-sided abdominal pain, shoulder-tip pain, or feeling faint or dizzy — these need emergency care immediately, as they can indicate an ectopic pregnancy.

Looking after yourself while you wait

  • Keep any follow-up scan or clinic appointments, even if you feel fine.
  • Write down your last menstrual period and any dates you're unsure of — this helps your team date the pregnancy accurately.
  • Start taking a 400 microgram folic acid supplement daily if you haven't already, and continue until 12 weeks.
  • Try not to search for worst-case scenarios online; every situation is assessed individually by people who can see your scan results.
  • Lean on your partner, a friend, or a pregnancy helpline if the uncertainty is weighing on you — this is a genuinely stressful situation and support is available.

Frequently Asked Questions

Can you actually get pregnant with an IUD fitted?

Yes, though it's uncommon — IUDs are one of the most effective contraceptive methods available, but no method offers 100% protection. If you have symptoms of pregnancy or a positive test while your coil is in place, contact your GP or EPU straight away for a scan to confirm the pregnancy's location and check the device.

Will the IUD be removed if I'm pregnant?

Usually, yes, if the threads are visible and removal looks straightforward, because leaving it in raises the risk of miscarriage, infection, and preterm labour. If the threads can't be found or removal seems risky, your clinician may advise leaving it in place and monitoring you closely instead — this decision is made case by case.

Is a pregnancy with an IUD more likely to be ectopic?

The overall risk of ectopic pregnancy while using an IUD is very low, but if a pregnancy does occur despite the coil, a higher proportion of those pregnancies turn out to be ectopic compared with pregnancies without contraception. This is why an early scan is so important — call your GP, EPU, or NHS 111 urgently if you have one-sided pain, shoulder-tip pain, bleeding, or feel faint.

This article is for informational purposes only and does not constitute medical advice. Always contact your GP, midwife, or Early Pregnancy Unit promptly if you suspect you are pregnant with an IUD in place.

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